DESCRIPTION: (Provided by the Applicant) Tobacco use and environmental tobacco smoke (ETS) exposure are profoundly important child health issues. Smoking is the leading preventable cause of death in the U.S., with as many as 43% of children living in a household with a smoker. Numerous guidelines recommend that pediatricians counsel to prevent smoking initiation, encourage ETS exposure elimination, and provide assistance to patients and parents with smoking cessation. To date, however, these guidelines have not been incorporated into routine pediatric health care. The proposed study is aimed at obtaining information needed to design both additional studies and efforts to translate research into improved practices and policies that will increase the rate and quality of pediatricians' counseling and other interventions to reduce tobacco use and prevent children's ETS exposure. A national random sample of 1,600 pediatricians from the American Academy of Pediatrics (AAP) will be surveyed about their attitudes toward, practices of, and barriers to providing interventions for tobacco cessation and limitation of ETS exposure. Survey questions will be created by a multidisciplinary research team with expertise in the current state-of-the-art of tobacco research, and administered as an AAP Periodic Survey, a well-tested instrument to assess member practices and opinions. Using data from prior AAP Periodic Surveys, trends in pediatric tobacco and ETS interventions will be determined. Pediatricians' perceptions of barriers to counseling will be assessed and correlated with behavioral stage of change, demographics and practice characteristics. The results of this survey will not only be published in peer-reviewed journals, but will be used as part of a broad-based national effort being developed by the AAP and its new Center for Child Health Research (CCHR) to better involve pediatricians and other child health clinicians in efforts to reduce children's exposure to ETS and reduce smoking rates among youth and their parents. This national effort will use data collected through the survey to: (1) develop and implement additional interventional research studies using the CCHR's Pediatric Research in the Office Setting (PROS) Network of nearly 1,600 practicing pediatricians; (2) develop and implement clinical policy and systems changes; and (3) create educational programs to make anti-tobacco activities a regular and effective part of the health promotion and disease prevention efforts of pediatricians. [unreadable] [unreadable]